The purpose of this article is not to provide details of the etiology of COVID-19 is (this has been done well by the World Health Organization) nor will it outline ‘simple steps to curing COVID-19’ (the science isn’t there yet). The intent behind this article is to offer an unbiased representation of what the literature so far has to offer on how natural health may support in this pandemic.
There will of course be arguments against natural health in the case of COVID-19. Fears of supplements being purchased excessively and of course the potential for false hope. On the other side of the equation, there are valid reasons for why natural health can, should and is being considered. Without an approved vaccine to prevent SARS CoV-2 infection and projections of at least 12 - 18 months before one is available, there’s potential for a long waiting game. That’s a lot of jobs lost due to physical distancing and more importantly, a lot of people unwell and possibly in need of hospitalisation. Hospitalisation that could potentially have been avoided.
Even in the absence of an infection, we all have a responsibility to remain healthy, well and productive. A responsibility even more relevant in the face of a pandemic with the added issues of stress, worry and lack of sleep. All of which have the ability to detract from immunity.
Key Considerations for Natural Health in the Face of a Pandemic.
Vitamin C: it’s a key contributor to immune function, a potent anti-inflammatory and rapidly expended in times of stress and infection. Vitamin C rich foods include berries (blueberries, strawberries and blackberries), capsicum, broccoli, citrus fruits, parsley, brussel sprouts and sweet potato. Try this Miami Vice Smoothie for a good dose of strawberries. A supplement may be necessary during times of significant stress.
Magnesium: deficiency can lead to stress while stress can perpetuate deficiency. Magnesium plays a crucial role in managing stress and therefore, the immune system. Green leafy vegetables, nuts and seeds are all great dietary sources of magnesium. A supplement may be necessary during times of significant stress.
Adequate sleep: evidence has shown that after just one night of partial sleep deprivation (10pm – 3am) natural immune responses are impacted. Stress often leads to poor quality sleep and deprivation, yet The American Sleep Association recommends 7 – 9 hours of sleep/night. For the sake of immune function, that should be every adult's goal.
Being vigilant of sugar intake: sugar is an immune suppressant and for anywhere between 1- 5 hours after consumption it reduces the capacity of white blood cells (part of our innate immune system) to function at their best. As best possible, avoid processed and packaged foods as they’re invariably sugar laden and nutrient deprived.
Nurture your digestive system and gut microbiome: so important to ensuring access to the beautiful immune boosting nutrients consumed in the diet as well as being the home to 70 – 80% of immune cells. Aim for 1 - 2 cups of non-starchy vegetables with every meal and explore fermented foods such as Kim-chi and miso.
Vitamin D: a nutrient which stimulates the maturation of immune cells. Research shows that those with the highest Vitamin D (125 – 150 nmol/L) have best protection against common colds and flu. So much so that there were 43% fewer cases of flu-like illness when compared to those with Vitamin D levels less than 50 nmol/L. Those with a history of Vitamin D deficiency should speak to their health provider before supplementing. See here for more on Vitamin D.
Key Considerations for the Role of Natural Health in the Specific Case of COVID-19.
Potential benefits can be better understood with some background on how SARS-CoV-2 infection progresses.
Stage I: an asymptomatic incubation period with or without detectable virus.
Stage II: non-severe symptomatic period with the presence of virus.
Stage III: severe respiratory symptomatic stage with high viral load. Evidence suggests about 15% of cases will reach this stage.
Clinically, the immune responses induced by SARS-CoV2 infections are two phased. During the First Phase, associated with incubation and non-severe symptoms, a specific adaptive immune response is required to eliminate the virus and prevent progression to the Second Phase (Stage III, above). It’s in the First Phase where good health and strategies to support immune response are considered by researchers to be worthy.
In an ideal world, on exposure to the virus the functions of the innate immune system would kick into gear, reducing the viral load and mitigating the likeliness of progression to Stage III. In some cases however, a delayed immune system response leads to a high viral load inducing a high cytokine response, referred to as a ‘cytokine storm’. This 'cytokine storm' could simply be thought of as excessive inflammation brought on by an immune system trying its best to cope. It’s for this reason physicians treating patients in China and the United States have been using high doses of intravenous Vitamin C as part of a more detailed treatment protocol. According to The New York Post, the patients who received Vitamin C did significantly better than those who didn’t get Vitamin C. A clinical trial on the effectiveness of intravenous Vitamin C in the case of coronavirus began in Wuhan, China on Feb 14th.
There are another 303 clinical trials that have been launched in China, investigating the efficacy of Traditional Chinese Medicine herbs, including astragalus and ginger. While 23 provinces in China have already issued Chinese Medicine programs for the prevention of COVID-19.
Researchers are also looking into the use of specially processed forms of Shitake mushrooms. Largely due the success of its use in other viral infections.
A systemic review of the literature, published in the Journal of Medical Virology not only details nutritional interventions for the general treatment of viral infections, but how nutrition could play a role in the specific treatment of COVID-19. Flavonoids (plant chemicals) have been cherry picked as a potential for their antioxidant and antiviral properties.
In Summary
It’s early days. The first case of COVID-19 was only detected in December 2019. The resounding sentiment within the literature is that good health is advantageous if not essential, in the initial stages of disease. We can use models of immune health to take an evidence-based approach to day to day health and nutrition in the face of a pandemic like COVID-19.
In parts of the world, natural health (such as Vitamin C and traditional Chinese herbs) is already being used in progressed states of the disease. Randomised control trials are still needed, but it’s exciting to think what may evolve from their current use and subsequent study findings.
I would love to hear from you should you have any queries about how your diet and lifestyle may, or may not, be supporting your own immunity during this time. 30 Minute Immune Boost Consultations are available or you can start by booking a 15-minute Complimentary Consultation in which we can discuss the best next steps for you.
Finally, whether it's me or another, please work with a healthcare professional before starting any supplements.
*Note: this article was written in 2020 prior to the availability of vaccines.
References
Irwin M et al. 1996. Partial night sleep deprivation reduces natural killer and cellular immune responses in humans.The FASEB Journal, 10, 5, 643 – 543.
https://www.newyorker.com/news/news-desk/how-long-will-it-take-to-develop-a-coronavirus-vaccine, accessed April 5th.
Shi Y et al. 2020. COVID-19 infection: the perspectives on immune responses. Cell Death Differ. https://doi.org/10.1038/s41418-020-0530-3
Mehta P et al. 2020. COVID-19: consider cytokine storm syndromes and immunosuppression. The Lancet, 395, 10229, 1033 – 1034.
https://nypost.com/2020/03/24new-york-hospitals-treating-coronavirus-patients-with-vitamin-c/, accessed April 5th.
Luo H et al. 2020. Can Chinese Medicine Be Used for Prevention of Corona Virus Disease 2019 (COVID-19)? A Review of Historical Classics, Research Evidence and Current Prevention Programs. Chinese Journal of Integrative Medicine, 26, 4, 243 – 250.
Di Pierro F et al. 2020. Possible therapeutic role of a highly standardized mixture of active compounds derived from cultured Lentinula edodes mycelia (AHCC) in patients infected with 2019 novel coronavirus. Minerva Gastroenterol Dietol. doi: 10.23736/S1121-421X.20.02697-5
Zhang L & Liu Y. 2020. Potential interventions for novel coronavirus in china: a systemic review. Journal of Medical Virology, 92, 5, 479 – 490.